Global prevalence of percutaneous injuries among healthcare workers: a systematic review and meta-analysis.

Background: Healthcare workers (HCWs) are at risk of occupational exposure to blood-borne pathogens through contact with human blood and other body fluids. This study was conducted to estimate the global and regional 1-year prevalence of percutaneous injuries (PCIs) among HCWs. Methods: We systematically searched EMBASE, PubMed, CINAHL and PsychInfo databases for studies published from January 2008 to January 2018 that reported the prevalence of PCIs among HCWs. A random-effects meta-analysis was conducted to estimate pooled prevalence of PCIs among HCWs. Results: Of the 5205 articles identified, 148 studies from 43 countries met the inclusion criteria. The pooled global 1-year prevalence estimate of PCIs was 36.4% [95% confidence interval (CI): 32.9-40.0]. There were substantial regional variations in the 1-year prevalence of PCIs, ranging from 7.7% (95% CI: 3.1-12.4) in South America to 43.2% (95% CI: 38.3-48.0) in Asia. The estimates for Africa and Europe were comparable with values of 34.5% (95% CI: 29.9-39.1) and 31.8% (95% CI: 25.0-38.5), respectively. The highest 1-year prevalence by job category was among surgeons, at 72.6% (95% CI: 58.0-87.2). The estimates for medical doctors (excluding surgeons), nurses (including midwives) and laboratory staff (including laboratory technicians) were 44.5% (95% CI: 37.5-51.5), 40.9% (95% CI: 35.2-46.7) and 32.4% (95% CI: 20.9-49.3), respectively. PCIs commonly occurred among HCWs working in hospital (41.8%, 95% CI: 37.6-46.0) than non-hospital (7.5%, 95% CI: 5.9-9.1) settings. Conclusions: Our findings suggest high rates of PCIs among HCWs with direct patient care across many regions of the world. However, paucity of data from some countries was a major limitation.

Hepatitis B vaccination coverage among health-care workers in Africa: A systematic review and meta-analysis.

OBJECTIVE: To estimate full hepatitis B vaccination coverage (uptake of ≥3 doses of vaccine) among health-care workers (HCWs) in Africa. METHODS: We systematically searched the PubMed®, Embase®, CINAHL and Psych-Info databases for studies published from January 2010 to October 2017 that reported full hepatitis B vaccination coverage among HCWs in Africa. A random effects meta-analysis was conducted to determine pooled estimates of full vaccination coverage. RESULTS: Of the 331 articles identified, 35 studies from 15 African countries met the inclusion criteria and were included in the review. The estimated full hepatitis B vaccination coverage was 24.7% (95% CI: 17.3-32.0). Regional coverage was highest in northern Africa (62.1%, 95% CI: 42.5-81.7) and lowest in central Africa (13.4%, 95% CI: 4.5-22.3). Doctors were more likely (OR: 2.6, 95% CI: 1.8-3.7) to be fully vaccinated than Nurses with estimated pooled estimates of 52.4% (95% CI: 31.1-73.8) and 26.3% (95% CI: 9.7-42.9), respectively. Also, HCWs with 10 or more years of experience were more likely to be vaccinated than those with less than 10 years of experience (OR: 2.2, 95% CI: 1.5-3.3). The common reasons identified for non-vaccination of HCWs were unavailability of vaccine 50.5% (95% CI: 26.5-74.4), busy work schedule 37.5% (95% CI: 12.6-62.4) and cost of vaccination 18.4% (95% CI: 7.1-29.7). CONCLUSION: The evidence available suggests that many HCWs in Africa are at risk of Hepatitis B infection as only a quarter of them were fully vaccinated against Hepatitis B virus. This study highlights the need for all African governments to establish and implement hepatitis B vaccination policies for HCWs.